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[腹部术前检查。无腹腔镜经腹肾上腺切除术的禁忌证]

[Abdominal preoperation. No contraindication for laparoscopic transabdominal adrenalectomy].

作者信息

Pohl P P, Meyer A, Lammers B J, Goretzki P E

机构信息

Klinik für Allgemein-, Visceral-, Gefäss- und Thoraxchirurgie, Städtische Kliniken Neuss,Lukaskrankenhaus-GmbH, Preussenstrasse 84, 41464, Neuss, Deutschland.

出版信息

Chirurg. 2008 Jun;79(6):571-5. doi: 10.1007/s00104-007-1400-y.

Abstract

Benign adrenal gland tumors smaller than 6 cm are nowadays the indication for minimally invasive surgery. Until now there has been no significant difference between retroperitoneoscopic and transabdominal adrenalectomy. Intestinal adhesions could be a contraindication against transabdominal laparoscopic adrenalectomy, and therefore the retroperitoneoscopic approach could be an advantage in these cases. A prospective study concerning this question has not been published yet. Our clinical investigation here includes 114 adrenalectomies during the last 5 years. We show that in any case of abdominal preoperation, laparoscopic adrenalectomy can be performed by transabdominal approach and without conversion to open surgery. Discussed are the different indications for laparoscopic adrenalectomy, operating time, conversion rate to open surgery, and amount and type of abdominal preoperation. We compared patients with and without abdominal preoperations.

摘要

如今,直径小于6厘米的良性肾上腺肿瘤是微创手术的适应症。到目前为止,后腹腔镜肾上腺切除术和经腹肾上腺切除术之间没有显著差异。肠粘连可能是经腹腹腔镜肾上腺切除术的禁忌症,因此在后一种情况下,后腹腔镜手术可能具有优势。关于这个问题的前瞻性研究尚未发表。我们在此的临床研究包括过去5年中的114例肾上腺切除术。我们表明,在任何腹部术前情况下,腹腔镜肾上腺切除术都可以通过经腹途径进行,而无需转为开放手术。讨论了腹腔镜肾上腺切除术的不同适应症、手术时间、转为开放手术的比例以及腹部术前的数量和类型。我们比较了有腹部术前准备和没有腹部术前准备的患者。

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